Definition

It is a skin inflammation (dermatitis) occurring when one is genetically susceptible to allergies (atopy).Atopic dermatitis (AD) often begins in childhood. It is not a contact allergy, but a constitutional type of eczema.The name “atopic” dermatitis is given because the patients concerned are atopic and have elevated total IgE. IgE are not responsible for the symptoms of eczema.Patients with atopic dermatitis have consequently a high tendency to develop other IgE-mediated allergies and should receive adequate preventive measures.

Symptoms

Eczema or dermatitis is more or less extensive.

Manifestations range from:

erythematous, scaly, oozing lesions

redness, itching

thickening of the skin (lichenization)

dehydration and skin excoriations (abrasions)

All above lesions may coexist in time or appear successively.

Etiology (cause)

The main cause is heredity. The trend of Atopic Dermatitis (AD) is genetically transmitted and increases if one or two parents are themselves atopic.

In some cases, foods are implicated as aggravating factors, typically bovine proteins (cow milk). When AD children consume cow’s milk, they have flares of eczema. Treatment consists of dietary measures (breastfeeding, milk with hydrolyzed protein).AD tends to easily be complicated by contact dermatitis (CD), because once the skin barrier is injured, allergens become more easily in contact with the immune system.

Treatment

AD is essentially treated by adequate rehydratation and use of corticoïds depending on symptoms.Skin infections if any are treated separately.Eventually, bovine proteins may need to be avoided.Good to know: when patients with AD are also allergic to dust mites, eviction of said dust mites together with treatment of this allergy (desensitization) often significantly improves AD (which will then require less corticosteroids).